Comparison of 12-step groups to mutual help alternatives for AUD in a large, national study: Differences in membership characteristics and group participation, cohesion, and satisfaction

Abstract

Background Many studies suggest that participation in 12-step groups contributes to better recovery outcomes, but people often object to such groups and most do not sustain regular involvement. Yet, research on alternatives to 12-step groups is very sparse. The present study aimed to extend the knowledge base on mutual help group alternatives for those with an alcohol use disorder (AUD), sampling from large, active, abstinence-focused groups including Women for Sobriety (WFS), LifeRing, and SMART Recovery (SMART). This paper presents a cross-sectional analysis of this longitudinal study, using baseline data to describe the profile and participation characteristics of attendees of these groups in comparison to 12-step members. Methods Data from participants 18 and over with a lifetime AUD (N=651) were collected using web-based surveys. Members of alternative 12-step groups were recruited in collaboration with group directors, who helped publicize the study by emailing meeting conveners and attendees and posting announcements on social media. A comparison group of current (past-30-day) 12-step attendees was recruited from an online meeting hub for recovering persons. Interested parties were directed to a webpage where they were screened, and eligible participants completed an online survey assessing demographic and clinical variables; in-person and online mutual help involvement; and group satisfaction and cohesion. Analyses involved comparing those identifying WFS, SMART, and LifeRing as their primary group to 12-step members on the above characteristics. Results Compared to 12-step members, members of the mutual help alternatives were less religious and generally higher on education and income. WFS and LifeRing members were also older, more likely to be married, and lower on lifetime drug and psychiatric severity; meanwhile, LifeRing and SMART members were less likely to endorse the most stringent abstinence goal. Finally, despite lower levels of in-person meeting attendance, members of all the 12-step alternatives showed equivalent activity involvement and higher levels of satisfaction and cohesion, compared to 12-step members. Conclusions Results suggest differences across 12-step groups and their alternatives that may be relevant when advising clients on a choice of mutual help group. Meanwhile, findings for high levels of participation, satisfaction, and cohesion among members of the mutual help alternatives suggest promise for these groups in addressing addiction problems.

Gambling Addiction Norway – experiences among members of a Norwegian self-help group for problem gambling

“…It has been suggested that non-religious self-help groups should be offered to those identifying as agnostic or atheistic (Zemore et al, 2017(Zemore et al, , 2018. While Gambling Addiction Norway can be described as non-religious, religion was not mentioned by any participant.…”

“…More broadly and taken together, the relational experiences reported by the participants may be understood as reflective of group cohesion, a construct which group psychotherapy research shows to be reliably associated with symptom reduction and better interpersonal functioning (Burlingame, McClendon, & Alonso, 2011). Experiencing group cohesion is also associated with better satisfaction with and involvement in various types of self-help groups for alcohol addiction (Kelly, Deane, & Baker, 2015;Moos, 2008;Zemore et al, 2017). Thus, participants in the current study reported experiences in accordance with findings on self-help groups for problem gambling, self-help groups for other conditions and group psychotherapy.…”

“…Some Norwegian problem gamblers may be sceptical of pre-defined beliefs, especially religious ones as Norway is a secular country with relatively low levels of church attendance (Kvande, Klöckner, & Nielsen, 2015). Irreligion has been found to predict drop out and less involvement in twelve-step self-help groups which has led to suggestions that alternatives should be provided for those identifying as agnostic or atheistic (Zemore, Kaskutas, Mericle, & Hemberg, 2017;Zemore, Lui, Mericle, Hemberg, & Kaskutas, 2018).…”

‘Berrypicking’ in the Formation of Ideas About Problem Drinking Amongst Users of Alcohol Online Support Groups

“…For example, Cain [16][17], Lave & Wenger [18] and Swora [19] amongst others have examined how AA transmits its beliefs through story-telling, radically altering users' ideas about the issue. There has been less attention paid to online AA and other 12step groups, and less still on non-12-step groups, as recently noted by Zemore [7], despite the fact that the latter are helpful alternatives to the AA approach. They expand the choices available to users who might not otherwise receive support.…”

“…This paper explores whether and how these groups impact on the beliefs about problem drinking held by their users. It focuses on the under-researched area [7] of groups that do not follow 12-step programs for recovery. The 12-steps were developed in the 1930s by Alcoholics Anonymous (AA) the most well-known and widespread support group for problem drinkers.…”